Wilcoxon Sign Rank Research Articles

Comparison Analysis of Financial Performance and Financial Distress before and during the Covid-19 Pandemic

The purpose study was to analyze a comparison of financial performance and financial distress before and during the Covid-19 pandemic in the Hotel, Restaurant, and Tourism sub-sector companies listed on the Indonesia Stock Exchange for the 2018-2021 period. In this study, a comparative descriptive method was used with a quantitative approach to test the impact of Covid-19 on financial performance and financial distress. The final sample of this study was 19 companies based on the elimination of the criteria that were only needed in this study. The proxies used to measure financial performance are profitability ratios (ROA, ROE, and NPM), while financial distress uses the Altman Z-Score model. Furthermore, these ratios were tested with a different test using the Wilcoxon sign rank test. The results showed that there were significant differences in the ratios of financial performance which included ROA, ROE, and NPM. Meanwhile, financial distress (Z-Score) also experienced significant differences between before and during the Covid-19 pandemic.

Analisis Perbandingan Pajak Hotel, Restoran, Reklame, Dan Retribusi Kebersihan Sebelum Dan Sesudah Pandemi Di Provinsi Aceh Periode 2018-2021

The COVID-19 pandemic in 2020 caused a decreased Revenue of Local Taxes and Retributions in Indonesia. In 2022, there will be a simplification for the types of Local Taxes and Retributions from Law Number 28 of 2009 to Law Number 1 of 2022 because there are too many types of Local Taxes and Retributions, which made monitoring difficult. This study aimed to analyze and compare Hotel Tax, Restaurant Tax, Billboard Tax, and Cleaning Retribution before and after the pandemic in Regencies/Cities of Aceh Province. Data analysis of the study used quantitative descriptive and comparative to compare the increased or decreased revenues between two samples before and after the pandemic. The results of the Wilcoxon Signed-Ranks Test show that there is a significant difference in revenue from Hotel Tax and Billboard Tax before and after the pandemic. Revenue from Hotel Tax experienced a significant decrease, while Revenue from Billboard Tax experienced a significant increase. Meanwhile, there is no significant difference between from Revenue Restaurant Tax and Revenue from Cleaning Retribution before and after the Pandemic.

The Combined Shewhart-CUSUM Wilcoxon Signed-rank Control Charts for Process Location

Nonparametric one- and two-sided combined Shewhart-CUSUM (CSC) control charts for process location based on the Wilcoxon signed rank (WSR) statistic are proposed. The statistical performances of these charts are investigated through Monte Carlo simulations, when the underlying process distributions are normal, uniform and Laplace. It is observed that a CSC WSR chart can be designed so as to exhibit a trade-off statistical performance between the performances of the Shewhart WSR and CUSUM WSR charts for identifying a location shift of any size. Hence, it is a viable alternative to these two charts in a case where efficient detections of the small as well as large-sized location shifts are equally important. Computations of the control statistics of a one-sided CSC WSR chart are illustrated using simulated-data example.. KEYWORDS :Statistical process control, Average run length, Distribution-free control chart

The Impact of M&A on Acquirers’ Financial Performance Across the Banking Industry - Case Study of the Gulf Cooperation Council 2017–2022

Objectives: The paper attempts to empirically assess the consequences of mergers and acquisitions (M&A) on acquirer banks' post-acquisition financial performance amongst the member banks of the Gulf Cooperation Council (GCC) region. This study explores M&A's impact on critical financial indicators such as profitability, operational efficiency, asset quality, and risk management, from the perspective of GCC banks operating from 2017 to 2022. Methods: A secondary data design was employed to better ascertain how acquirers in the GCC banking industry perform after M&A. The design is characterized by collecting the performance data and conducting statistical analyses (descriptive analytics, and Kolmogorov-Smirnov, Shapiro-Wilk, and Wilcoxon Signed-Rank tests) using the SPSS tool to draw inferences. Conclusion: The research found that there is a negative impact on the performance measures of the acquirer following an M&A. However, with the exception of the size and age of the firm, this impact is statistically insignificant. To understand the performance measures that are impacted by the M&A. This research also explores the various external factors that influence the impact of M&A on performance measures. The insights from this study can be used by stakeholders when acquiring organisations to obtain a clear understanding of the possible impacts of an M&A on the organisations' performance. This paper contributes to exploring the diverse factors that may influence the impact of M&A on the performance of the acquirer, including the size of the sample, transaction model, accounting policies, and observation period. This differentiates this study from the majority of the existing research where the focus is on performance only.

Mastery Learning in Preclinical Endodontics Using Customized 3D-Printed Tooth Models for Deliberate Practice: An Application of Educational Design Research

IntroductionThis study, conducted within an educational design research (EDR) framework, assessed the use of customized 3D-printed tooth models at various difficulty levels to enhance mastery learning and deliberate practice in preclinical endodontic training. MethodsThe EDR was conducted in a preclinical endodontic training involving 42 third-year students. The study focused on developing and evaluating 3D-printed tooth models customized into 3 difficulty levels to facilitate mastery learning for the access opening procedure on upper anterior teeth. To promote deliberate practice, we ensured ample availability of these models. The evaluation combined quantitative analysis, using Friedman and Wilcoxon Signed-Rank tests to assess practice volume and performance, with qualitative feedback from interviews and focus groups, analyzed via content analysis. ResultsThere was a significant reduction in practice time across the different model levels, with students using an average of 1.5–1.8 models per level. No significant differences in performance scores were observed across levels and natural tooth (P = .333). Feedback highlighted the models' educational value in enhancing dental training, indicating their effectiveness in improving learning experiences and skill development in endodontic education. ConclusionsThe innovative design of a 3D-printed tooth model system, which features 3 levels of difficulty and was developed within an EDR framework, allowed for tailored learning progressions and ample practice opportunities. This significantly enhanced the endodontic training experience and skill development by providing varied and realistic challenges.

Enhancing inpatient chemo/immunotherapy stewardship: A novel scoring rubric approach to optimize utilization and reduce costs.

11130 Background: Most inpatient chemo/immunotherapy (IC) is not reimbursed because of the diagnosis-related group code structure for reimbursement. We implemented the use of a novel objective scoring rubric to guide and automate IC stewardship at an academic cancer center to decrease the inappropriate use of IC especially at the end of life. Methods: We created a scoring rubric for non-formulary IC that includes type and phase of trial, FDA/NCCN approvals, performance status, line, and goal of therapy. Clinicians enter these criteria in a Redcap form which automatically calculates a score which is then verified by 2 disease specific physicians and a clinical pharmacist. If the threshold score is not met, IC is not approved for administration. IC that is on formulary and standard of care is automatically approved. We compared post-implementation year 1 (1/2022-8/2022) to post-implementation year 2 (1/2023-8/2023) on two primary outcomes: drug cost and utilization. Comparisons were assessed using the Wilcoxon Signed-Rank Test. Results: There was a total of 74 requests with 12% not approved in 2022 compared to 96 with 14% not approved in 2023. We compared the median values of the number of times each non-formulary IC was dispensed from January to August in both 2022 (median=6) and 2023 (median=2), p= 0.01. In 2022 the median of average monthly IC drug charges was $$840730 compared to $434586 in 2023 (p= 0.02). In 2022 the median of average monthly ICI drugs was($91651) compared to $55368.35 (p= 0.25) for 2023. The total annual charge of IC decreased by 44% from 2022 to 2023 with the total annual charge of immune checkpoint inhibitors decreasing by 26% (Table). Conclusions: Implementation of a novel objective scoring rubric for IC stewardship effectively reduced inappropriate administration, as evidenced by a significant decrease in the number of times non-formulary IC was dispensed and a substantial reduction in drug charges. The total annual charge of IC significantly decreased by 44% showing a sustained improvement over a 2 year period. This approach offers a promising strategy to optimize resource utilization and ensure appropriate utilization of IC, particularly in patients nearing the end of life. Further studies are warranted to evaluate the long-term impact of this intervention on patient outcomes and healthcare costs.[Table: see text]

Improving clinical trial performance using adult-learning methods.

11025 Background: Timely and efficient accrual to oncology treatment trials is among the most vital components of clinical research. However, more than 80% of trials fail to reach enrollment targets, compromising outcome interpretation and cost. We hypothesized that a novel and customized application of adult-learning methods would enhance clinical trial screening and randomization. Methods: In collaboration with a multinational sponsor, Vaniam Group (VG) introduced a structured set of interventions to sites in 3 global randomized trials. Sites choosing to “opt in” formed the experimental group (EG). EG received tailored interventions: interactive Trial Educational Discussions (iTEDs: 30-min virtual meetings), and/or interactive Trial Acceleration Meetings (iTAMs: 4-hr live workshops of 10-30 investigators), and standard study support. Adult-learning techniques including the Socratic Method, case studies, and teach-back were used. Control group (CG) comprised sites receiving only standard study support. Primary endpoints were screening rate (SR) and randomization rate (RdR) compared atbaseline (6 mos prior to intervention) and 6 mos post-intervention (M6). Nonparametric statistical analyses compared between-group (Mann–Whitney U test) and within-group (Wilcoxon Signed-Rank test) differences. Results: Trial 1, a phase 3 placebo-controlled adjuvant trial had been open for 45 mos (54% enrolled) prior to intervention. At baseline, SR and RdR were similar between groups ( P>0.05). At M6, SR increased 100% and RdR increased 37% in the EG; in the CG, SR did not change and RdR decreased 7%. For both endpoints, EG performed better than CG ( P=0.018, P=0.014). Trial 2, a phase 3 neoadjuvant trial had been open for 49 mos (86% enrolled) with a projected 18 mos to completion. At M6, SR increased 3% in the EG, but decreased 39% in the CG. RdR increased 15% in the EG but decreased 33% in the CG. While changes in performance were not significant between groups ( P >0.05), study met its target enrollment goal with no further delays. Trial 3, a phase 2 recurrence trial was 30% behind enrollment with a projected 51 mos to completion. At M6, increases in SR were recorded in both EG and CG at 116% and 18%, respectively. RdR increased in both EG and CG (90% and 50%, respectively), augmented by protocol amendment. Despite increases in both groups, SR and RdR were significantly enhanced by VG intervention ( P=0.009 and P=0.015). Conclusions: Our novel, site-focused intervention strategy structured upon adult-learning methods significantly enhanced clinical trial performance, as measured by SR and RdR. Future work will expand these findings to different trial designs and outcome measures such as endpoint fidelity and cost. [Table: see text]

Online vs in-person musculoskeletal ultrasound course: a cohort comparison study

BackgroundPoint-of-care musculoskeletal (MSK) ultrasound (US) courses are typically held in-person. The COVID-19 pandemic guidelines forced courses to switch to online delivery. To determine this impact, we conducted an observational cohort study, comparing homework completion and image quality between an Online and a historical In-person cohort.MethodsThe In-person (n = 27) and Online (n = 24) cohorts attended two learning sessions spaced six months apart. The course content was the same, while the process of delivery differed. As homework, participants submitted US images biweekly for up to five months after each session. Expert faculty provided written feedback to all participants, and two independent reviewers rated the image quality for a subset of participants in each group who had completed at least 70% of their homework (In-person, n = 9; Online, n = 9). Participants self-reported their satisfaction through post-course evaluation.Results63% of In-Person and 71% of Online cohort participants submitted their homework images. We observed no differences in the mean amount of homework images submitted for In-person (M = 37.3%, SD = 42.6%) and Online cohorts (M = 48.1%, SD = 38.8%; p > 0.05, Mann-Whitney U Test). At course end, the cohorts did not differ in overall image quality (p > 0.05, Wilcoxon Signed-rank Test). All participants reported high levels of satisfaction.ConclusionsA convenience sample of participants attending a basic MSK US course in-person and online did not differ statistically in homework completion, quality of submitted US images, or course satisfaction. We add to literature suggesting online learning remains a viable option post-pandemic.

The Effect of Solution-Focused Approach on Reducing Smartphone Addiction

The aim of this study is to examine the effect of solution-focused group counseling on reducing smartphone addiction among university students. The research is an experimental study with experimental-control group with pre-test, post-test and follow-up measurement design. The study group of the research consisted of 22 university students (10 females and 12 males). 11 of these students are in the experimental group (5 females and 6 males) and 11 of them are in the control (5 females and 6 males) group. A solution-focused group psychological counseling program was applied to the experimental group to reduce smartp-hone addiction, consisting of six sessions (90-120 minutes once a week) developed by the researcher. Kontrol grubuna ise herhangi bir çalışma yapılmamıştır. In this study, "Smartphone Addiction Scale" and "Personal Information Form" were used as data collection tools. The data obtained from this study were analyzed using the Mann Whitney U Test and the Wilcoxon Signed-Ranks Test. The findings of the study revealed that the solution-focused group was more effective than the control group. In addition, it was observed that this effectiveness was preserved with the follow-up studies carried out at the end of three months

OPTIMIZATION OF DRIED BLOOD SPOT ASSAYS FOR HEPATITIS B VIRUS SURFACE ANTIBODY QUANTIFICATION.

Dried blood spot (DBS) cards can be used as an alternative sample collection method to plasma, however, there is no optimized elution protocol for DBS cards specifically for hepatitis B surface antibody (anti-HBs) testing. The study aimed to develop a DBS elution protocol for anti-HBs quantification. Our study sought to determine the ideal phosphate-buffered saline (PBS) buffer volume to use by comparing three PBS volumes (300uL, 450uL, and 500uL), and the optimal time to agitate DBS discs on a plate shaker (1hr, 2hrs, 3hrs, and 4hrs) to yield DBS anti-HBs concentrations that are comparable to corresponding plasma anti-HBs concentrations. The optimal DBS storage temperature (25°C, -20°C, and -80°C) was investigated to determine the ideal long-term storage temperature of the cards. Residual samples were used for optimization (2019-2021). A total of 50 DBS-plasma pairs was used throughout the study, with plasma anti-HBs concentrations being used as the golden standard to compare. The analysis of results was carried out by determining the p-values of the Wilcoxon sign rank. A two-way analysis of variance (ANOVA) was also performed to determine the impact of PBS elution volumes, elution time, and storage temperature on the anti-HBs concentration of DBS samples on STATA Version 15.0. No statistically significant difference between the DBS-plasma anti-HBs pairs was observed when using 450 or 500uL of PBS buffer and when samples were agitated for 3 hours (p=0.594, p=0.499 respectively). The optimal storage temperature for DBS cards was 25°C because the results showed no statistically significant difference between DBS-plasma anti-HBs titers (p=0.594). The two-way ANOVA analysis showed that elution volumes and time had no statistically significant impact on the DBS anti-HBs concentrations, p=0.948 and p=0.381 respectively. Storage temperature had a statistically significant impact on the DBS anti-HBs concentrations, p=0.002. The optimized DBS elution protocol for anti-HBs quantification will help monitor vaccine efficacy in infants due to the low sample volumes required compared to plasma and also can be used for anti-HBs testing in resource-limited areas around the country.

A Novel Coated Suture Displays Antimicrobial Activity Without Compromising Structural Properties

BackgroundTreated or coated sutures promise to prevent contamination of wounds. PurposePurpose of the study was to coat surgical sutures with a new quaternary ammonium silane (QAS) antimicrobial compound at two different application temperatures and then to evaluate resulting structural, physical, mechanical, and biological properties. Study Design, Setting and SampleIn-vitro and in-vivo studies were conducted using male albino Wistar rats approved by Joint Ethical Committee of IMU and Postgraduate Medical Institute, Lahore. Only suture samples, coated uniformly with verified presence of the compound and of adequate length were used. Samples which were not coated uniformly and with inadequate length or damaged were excluded. Predictor VariablesPredictor variables were sutures with and without QAS coatings and different temperatures. Sutures were coated with QAS at 0.5% and 1.0% wt/vol using dip coating technique and sutures with and without QAS coating were tested at 25oC and 40oC temperatures. Main Outcome VariableOutcome variables of structural and physico-mechanical, properties of QAS coated and non-coated sutures were measured using Fourier transform infrared spectroscopy (FTIR) (for structural changes), confocal laser and scanning electron (for diameter changes), and tensile strength/modulus (for mechanical testing). Biologic outcome variables were tested (bacterial viability); macrophage cultures from Wistar rats were tested (M1/M2 polarization detecting IL-6 and IL-10). Macrophage cells were analyzed with CD80+ (M1) and CD163+ (M2). Chemotaxis Index was calculated as a ratio of quantitative fluorescence of cells. CovariatesNot applicable. AnalysisOrdinal data among groups were compared using Wilcoxon Mann-Whitney U test along with comparison of histological analysis using Wilcoxon Sign-rank test (p < 0.05). ResultsFTIR peak at 1490 cm-1 confirmed presence of QAS on suture’s surfaces with significant increase (p<0.05) in diameter (0.99±0.5-mm) and weight (0.77±0.02-mg) observed for 1% QAS-groups treated at 40°C. Non-coated samples heated at 25°C had significantly (p<0.05) less diameters (0.22±0.03-mm) and weights (0.26±0.06-mg). Highest tensile strength/modulus was observed for 0.5% QAS-coated samples which also had significantly high antibacterial characteristics than other sutures (p<0.05). QAS-coated sutures significantly increased M1 and M2 markers. Conclusions and RelevanceQAS coating conferred antibacterial action properties without compromising physical and mechanical properties of the suture.

The Effect of Virtual Reality Gaming on Developing Computational Thinking Skills

In the digital age, where programming prowess is increasingly crucial, the enhancement of Computational Thinking (CT) skills becomes essential. This study ventures into the scarcely explored domain of leveraging game-based learning (GBL) within virtual reality (VR) settings to bolster CT skills. Specifically, it introduces "CT Saber," a VR game inspired by the popular "Beat Saber," tailored to cultivate CT competencies. Employing a Design and Development Research (DDR) methodology across five stages—analysis, design, development, implementation, and evaluation—this investigation assessed the game's impact on 37 computer science students (25 male, 12 female) aged 21-24. A quasi-experimental design with pretest-posttest evaluation was utilized, revealing significant enhancements in CT skills post-intervention (Z = -4.496, p &lt; 0.05), as analyzed through Wilcoxon Signed-Rank tests. The findings underscore the VR game's efficacy in CT skill development, suggesting a promising direction for integrating VR technologies in programming education.

Quad Shot Palliation, A Considerable Option for Non-Osseous Recurrent or Metastatic Malignancies in Elderly or Frail Patients.

Background: Palliative radiation therapy (RT) is increasingly recognized as a crucial component of care for patients with advanced, incurable malignancies. In Pakistan, where patients often present at advanced stages due to socio-economic barriers and limited healthcare access, efficient and effective treatment protocols are essential. Objective: This study aimed to evaluate the efficacy of the Quad Shot hypo-fractionated RT protocol for pain palliation in elderly and frail patients with recurrent or metastatic non-osseous malignancies. Methods: A quasi-experimental study was conducted at the Oncology Department of Ganga Ram Hospital, Lahore. Forty-two elderly patients with histologically confirmed inoperable malignancies and a WHO Performance Status of 2 to 3 were enrolled. Patients with prior RT or a second cancer were excluded. RT was delivered using a Cobalt-60 beam, with a total dose of 14 Gy divided into four fractions over two consecutive days. Pain severity was assessed using a 10-point scale before and four weeks after treatment. Statistical analysis was performed using the Wilcoxon Sign Rank Test on SPSS version 25.0. Results: The study population comprised 52% males and 48% females, with the majority of primary tumors located in the head and neck (64%). Post-treatment, the mean pain score significantly decreased from 8.04 ± 1.22 to 4.32 ± 0.89 (p &lt; 0.05). Conclusion: The Quad Shot hypo-fractionated RT protocol effectively reduces pain in elderly and frail patients with advanced malignancies, suggesting its suitability as a quick and effective palliative care option in resource-limited settings.

An enhancement of the Genium™ microprocessor-controlled knee improves safety and different aspects of the perceived prosthetic experience for unilateral and bilateral users.

Bilateral microprocessor-controlled prosthetic knee (MPK) users have unique needs in traversing environmental barriers compared to unilateral users. An enhancement to the Genium™/Genium X3™ MPK which included an updated ruleset, hydraulics, and new bilateral parameter presets was made to improve safety while stumbling and the smoothness of gait for all users while also improving the experience of bilateral users. The purpose of the study was to evaluate the effectiveness of the enhancements in a sample with unilateral and bilateral amputation. A convenience sample of MPK users was recruited from two sites in the USA in two phases. Assessments included the L-Test of Functional Mobility, Activity-specific Balance Confidence Scale, Prosthetic Limb User Survey of Mobility, a study-specific questionnaire, and the Comparative Activities of Daily Living (ADL) Questionnaire. Statistical significance of extracted data was tested with the Wilcoxon Rank-Sum Test for independent data and Wilcoxon Signed-Rank for paired data with an a priori significance level of p < 0.05. Unilateral subjects were age-matched to the group of bilateral subjects for between-groups and within-groups analyses. Twenty-six subjects (n = 26) were enrolled. Stumble frequency reduced 85% from 16.0 ± 39.7 to 2.4 ± 2.3 (p = 0.008) between baseline and final assessment overall. The bilateral group reported 50% (p = 0.009) and 57% (p = 0.009) greater relative improvement in patient-reported ease and safety, respectively, of completing ADLs compared to the unilateral group. The unilateral group reported residual limb pain and low back pain reduced from 2.3 to 1.4 (p = 0.020) and 3.8 to 1.8 (p = 0.027), respectively, whereas the bilateral group did not. Substantial reductions in stumbles, residual limb pain, and back pain were shown overall. These reductions were driven by the unilateral group who also showed improvements in comfort, exertion, and concentration while walking. The enhancements to the knee likely reduced some gait asymmetry for unilateral users. Improvements in patient-reported ease and safety of completing ADLs were shown overall and were driven by the bilateral group. This study shows further improvement in patient experience is achievable through innovation in MPK technology even for patients who appear to be functioning well.

Analysis Of The Financial Performance Of Insurance Companies Before And During The Covid-19 Pandemic Based On Early Warning System And Risk-Based Capital

This study aims to provide empirical evidence regarding the comparison of the value of the Early Warning System and Risk-Based Capital in measuring the financial performance of insurance companies before and during the COVID-19 pandemic. The Early Warning System measurement indicator uses the claim expense ratio. Sampling using purposive sampling method and obtained a sample of 18 insurance companies listed on the Indonesia Stock Exchange (IDX) for the period 2017-2022. The type of data used is secondary data in the form of financial reports collected through the company's official website and the Indonesia Stock Exchange (IDX). The data analysis method uses non-parametric statistics, namely the Wilcoxon Sign Rank Test with the help of SPSS version 27. The results prove that there is a significant increase in the value of the Early Warning System during the pandemic compared to before the Covid-19 pandemic. The Risk-Based Capital value did not experience a significant decrease during the pandemic compared to before the Covid-19 pandemic. In addition, in this study, the Early Warning System is considered more accurate than Risk-Based Capital because it has a smaller standard error.

Decreased moment of inertia of the lower limb facilitates a rapid hip internal rotation in a simulated foot impact maneuver. A laboratory-controlled biomechanical study for a precursor mechanism of noncontact anterior cruciate ligament injury.

Anterior cruciate ligament injury frequently occurs in the deceleration with the knee-extended position. In addition, a rapid hip internal rotation is concomitantly observed. However, how the extended knee position induces the hip internal rotation is unclear. Sixteen healthy participants performed the simulated foot impact task on the experimental chair. To vary the knee flexion angle, the following four-foot placement positions relative to the pelvis segment, i.e.: 1) near; 2) middle; 3) far; and 4) far + heel strike, were tested. The reflective marker positions and the ground reaction force (GRF) data were collected. The moment of inertia of the entire lower limb around its long axis as well as the peak hip internal rotation angular velocity were calculated and compared among four conditions (Wilcoxon Signed-Rank Test with Bonferroni correction, P<0.0083). As the knee extended from the near to far + heel strike condition, the moment of inertia of the entire lower limb significantly decreased and hip internal rotation angular velocity significantly increased (P<0.001). The extended knee position with far foot placement from torso reduces the inertial resistance of the entire lower limb around its long axis and is vulnerable to the hip internal rotation.

Common radiographic indices used to measure patellar height do not consistently identify patella alta and lack interchangeability between measurements.

Abnormal patellar height has been identified as a source of aberrant mechanical functioning within the patellofemoral joint. The purpose of this study is to examine the statistical agreement among three commonly used classification methods: Blackburne-Peel (BPI), Caton-Deschamps (CDI) and Insall-Salvati (ISR), by evaluating (1) the rates of patella alta identification and (2) the ability for one index to predict another. One hundred lateral knee radiographs were evaluated using BPI, CDI and ISR to classify each knee as patella normal, patella alta or patella baja. Linear regression analysis was performed to evaluate the relationship between each index. Conversion equations were then derived using the reported linear regression best-fit line, comparing each pair of indices. Patella alta was identified in 15 knees using BPI, 15 using CDI and 25 using ISR. A total of seven knees were classified as patella alta by all BPI, CDI and ISR. Statistical analysis revealed significant correlation (p ≤ 0.001) among BPI and CDI (R2 = 0.706), BPI and ISR (R2 = 0.328) and CDI and ISR (R2 = 0.288). Wilcoxon Signed-Rank test between the three indices revealed no significant difference between the means of converted and original indices. Despite their significant correlations and adequate reproducibility, variability between common patellar height indices render predictions and conversions between BPI, CDI and ISR inequivalent. Users of these indices must be aware of their incongruent properties when considering application to patients in the clinical setting. Furthermore, it remains unclear which patellar height measurement technique is the correct index to use in a given knee. This study highlights the need for further investigation to create a reliable and standardised method for identifying patella height. Level IV.

Pengaruh Yoga Pranayama dengan Tingkat Stres Perawat yang Bertugas di Ruang Operasi Rumah Sakit Balimed Denpasar

Background: Nurses working in the operating theatre are prone to stress because they are required to have high knowledge and concentration skills in all aspects of perioperative care. Stress management can be done through relaxation with yoga pranayama. Purpose: The purpose of this study was to determine the effect of yoga pranayama on the stress level of nurses on duty in the operating room. Methods: This study used a pre-experimental design with a one-group pre-post test design. The research sample was 23 nurses in the operating room with purposive sampling technique. Data collection using Perceived stress scale questionnaire, analysis using Wilcoxon Sign Rank test. Results: The results showed that the stress level of pre-test nurses was mostly 16 people (69.6%) in the moderate category and the post-test was entirely 23 people (100%) in the mild category. The results of the Wilcoxon Sign Rank Test obtained Zhitung = 4.199&gt; Ztabel = 1.96 and p value = 0.001 &lt;0.05 these results indicate there is an effect of yoga pranayama with the stress level of nurses on duty in the operating room. Conclusion: The results of the study can be concluded that yoga pranayama has a significant effect on the stress level of nurses on duty in the operating room. It is recommended that nurses do Yoga exercises can be done regularly at least once a day to help reduce stress.

Validity and Reliability of the Korean Version of the Communication Acceptance Scale Questionnaire

Purpose: The purpose of this study was to develop the Korean version of the Communication and Acceptance Scale (KCAS) and to examine its validity and reliability.Methods: The 18 items of the Communication and Acceptance Scale questionnaire were translated into Korean following the steps of forward translation, expert panel review, back-translation, pre-testing, cognitive interviewing, and final version refinement. For the test-retest evaluation of the KCAS, 39 adults with hearing loss participated. Concurrent validity was also assessed by evaluating the Korean Hearing Handicap Inventory for the Elderly (KHHIE).Results: The KCAS was constructed with a total of 16 question items after excluding 2 items (2 and 18) that failed reliability tests. Cronbach’s α for all 16 items was 0.89, and the Wilcoxon-Signed rank test indicated test-retest reliability. A significant negative correlation (rho = -0.77) was observed between KCAS and KHHIE.Conclusion: The KCAS questionnaire has been demonstrated to be a reliable and valid tool. It is also useful for assessing communication difficulties and the utilization of communication strategies among the hearing impaired.

Harmonizing musculoskeletal health: transformative effects of 8-week intervention program on posture in music students

Background and Study Aim. Musculoskeletal complaints are common among music students, irrespective of gender. They develop due to intense practice over an instrument; spending long hours of practice may cause muscular imbalance, tension, and awkward posture. The repetitive nature of practice in music students may cause overuse and fatigue. This increases the risk of acute pain and can affect both quality of life and performance. Therefore, the present study aimed at evaluating the transformative effects of an 8-week intervention program on posture in music students. Material and Methods. The 8-week intervention program with transformative effects was conducted over 8 weeks (from September 18 to November 12) on Mondays and Thursdays, for 45 minutes each session. The program aimed to benefit 25 music students, of whom (i) 15 were in the experimental group (with an average age of 24.20 years, average weight of 82.40 kg, and average height of 178.60 cm), and (ii) 10 were in the control group (with an average age of 24.60 years, average weight of 78.40 kg, and average height of 182.20 cm). All participants were enrolled in the second year of a master's degree program in Performing Arts. Standardized measures for evaluating posture (utilizing Klein and Thomas's method, as refined by Mayer) were conducted both before (Week 1, September 18) and after (Week 8, November 12) the intervention. The impact of the 8-week intervention program was assessed using the Wilcoxon Rank-Sum Test, Wilcoxon Signed-Rank Test, and Pearson's r. Results. Significant differences (p ˂ 0.05, ˂ 0.01) between 25 music students (M); in particular experimental group (n = 15) and control group (n = 10), were in 4 (80%) segments of body in post-test: (i) Head and neck; (ii) Abdomen and pelvis; (iii) Curvature of spine; (iiii) Shoulders and scapulas. Insignificant differences (p ˃ 0.05) between 25 music students (M) were in pre-test. Conclusions. Significant differences (p ˂ 0.05, ˂ 0.01) indicated the transformative effects in the experimental group's (n = 15) posture. This emphasizes the potential of the 8-week intervention program in promoting musculoskeletal health of music students. Therefore, additional research is necessary to investigate the lasting resilience (sustainability) of advantages and enhance the intervention plan in music education.